Author/Editor		Sinkovič, Andreja
Title		Akutno srčno popuščanje - prepoznavanje in zdravljenje
Translated title		Acute heart failure - diagnosis and treatment
Type		članek
Source		In: Hojs R, editor. Zbornik prispevkov 20. srečanje internistov in zdravnikov družinske medicine "Iz prakse za prakso" ; 2009 maj 8-9; Maribor. Maribor: Univerzitetni klinični center,
Publication year		2009
Volume		str. 105-11
Language		slo
Abstract		Acute heart failure (HF) is an important cause of morbidity, mortality and hospital admission. Patients with acute HF stay in hospitals in average for 9 days, half of them are readmitted in the next 12 months, but after 60 days 30-50% of those patients die or are readmitted to the hospitals. Acute HF is defined as rapid onset of new or worsening of symptoms and signs of HF, necessitating immediate treatment and interventions. Six clinical categories of acute HF represent acute worsening of chronic HF, pulmonary edema, hypertensive HF, cardiogenic shock, isolated right heart HF and most frequent category acute coronary syndrome with acute HF. To establish correct diagnosis clinical signs and symptoms, ECG, chest rentgenograph, laboratory findings, including blood gases and levels of natriuretic peptide as well as echocardiography are important. During treatment close monitoring of patients is mandatory. Early goals of treatment are to improve acute clinical situation and to prevent further organ damage, long-term goals are to start the optimal treatment strategy, including pharmacological , short in-hospital stay, education, secondary prevention, improved quality of life and survival. Treatment includes several pharmacological agents and procedures such as oxygen, morphine, diuretics, inotropes, catecholamines, noninvasive or mechanicalv entilation, coronaryr evascularizationi,n sertion of intra-aortic ballonp ump, operation, etc.
Summary		Akutno srčno pupuščanje (SP) je pomemben vzrok za obolevnost, hospitalizacijo in umrljivost. Bolniki z akutnim SP so povprečno hospitalizirani 9 dni, polovica ponovno v naslednjih 12 mesecih, po 60 dneh umre ali je ponovno hospitaliziranih 30-50% bolnikov. Definicija akutnega SP je hiter nastanek novih simptomov in znakov SP ali poslabšanje kroničnega SP, kar zahteva takojšnje zdravljenje in ukrepe. Šest kliničnih kategorij akutnega SP predstavljajo akutno poslabšanje kroničnega SP, pljučni edem, hipertenzivno akutno SP, kardiogeni šok, izolirano akutno SP desnega srca in najpogostejša kategorija akutni komami sindromi z akutnim SP. Za postavitev diagnoze je pomembna anamneza, klinična slika, EKG, rentgenska slika pljuč in srca, osnovni laboratorijski testi in ehokardiografija. Med ukrepanjem in zdravljenjem je potreben nadZor bolnikov. Zgodnji cilji zdravljenja so izboljšanje klinične slike in preprečevanje posledičnih organskih okvar, dolgoročni cilji pa uvedba optimalne strategije zdravljenja, vključno farmakološke, skrajšanje hospitalizacije, izobraževanje, sekundarna preventiva, izboljšanje kvalitete življenja in preživetja. Zdravljenje obsega številna farmakološka sredstva in ukrepe kot je dajanje kisika, morfija, diuretika, inotropnih sredstev, kateholaminov, neinvazivno ali mehanično predihavanje, koronamo intervencijo, vstavitev intraaortne balonske črpalke, operacijo, itd.